States had until Friday to decide if they wanted to establish their own health care exchanges — online “marketplaces” that will let millions of people nationwide compare and purchase health coverage.

Earlier this week, Florida lawmakers announced they were not ready to develop their own and would accept the federal government’s version of the exchange for now.

The exchanges are one part of the complex Affordable Care Act long resisted by Gov. Rick Scott and Republican state legislators.

Nothing had been done in Florida to establish a framework for an exchange before the 2012 election, as opponents hoped for a Republican president who would ditch or modify the law.

When President Barack Obama won re-election, Republican-led states had little time to figure out how to get the exchanges ready by Jan. 1, 2014.

Jay Wolfson, a professor of health law and policy at the University of South Florida, said Thursday that Floridians will be better off with the federal plan at this time.

For one thing, the federal exchange will have a larger risk pool, which could lead to lower insurance policy premiums, he said.

And he agreed with legislators: The state simply is not ready.

“Who is best prepared to work with partners to provide people like you and me health insurance at a reasonable price?” Wolfson asked. “The federal government has more information and access to achieve this.”

In late November, Florida CHAIN, a consumer health advocacy organization based in Tallahassee, sent a petition with about 10,000 signatures to the head of the U.S. Department of Health and Human Services, asking that states be held to Friday’s deadline.

It also stated the organization’s belief that Florida was ill-prepared to create an exchange, accusing state leaders of “stalling.”

“We feel Florida wasted a lot of time and money and there’s now no time to do an exchange,” said Florida CHAIN spokeswoman Leah Barber-Heinz.

According to an Associated Press poll, 19 states have turned down the administration’s invitation to set up the exchanges, while 17 states and Washington, D.C., say they will set up their own markets.

Eight states have indicated they want to pursue a partnership with Washington, and six remained undecided as of Thursday.

All of the states refusing are led by Republicans.

Drafters of the law did not anticipate that so many states would remain on the sidelines at this late stage. Getting the system rolled out on time will be a defining challenge for Obama’s second term.

In addition to a consumer-friendly website offering comparisons of plans, the exchanges must operate a toll-free call center, offer a streamlined process for applying, and provide assistance for non-English speakers and others needing extra help.

The partnership option between the federal government and each state remains on the table; states have until Feb. 14 to let Washington know.

That option would require approval by the Florida Legislature and governor, and they plan to debate the issue when the session begins in March — after the deadline. The state House and Senate have set up special committees to review the federal health care law, including the exchanges.

Karen Woodall, director of the Florida Center for Fiscal and Economic Policy, said it is a good sign that Scott and state officials are trying to work with the federal government.

“We have not been doing anything to prepare for all that is involved with the implementation,” Woodall said. “It’s too important and it affects too many people.”

Barber-Heinz said her organization would support a state exchange — when Florida is ready.

“It would be ideal for that to eventually happen because Florida regulates its own insurance industry and Florida knows best what Florida needs,” she said. “Unfortunately, that ideal place is not where we are at all at this point.”

Scott, a former health care executive, said he wants to meet with Obama to express his concerns about the cost of both the exchanges and the proposed expansion of Medicaid, another major component of the ACA.

“I want to do what’s good for Floridians,” Scott said Thursday. “What do they need? They need lower health care costs. They need good access and good quality.”

The estimated price tag for the federal exchange is at least $860 million.

H-T Capital Bureau reporter Lloyd Dunkelberger contributed to this report, which also contains information from the Associated Press.

Donna Koehn

Donna Koehn covers health, both news from the area’s hospitals and human interest stories on issues of medical care and concerns. Hailing from the Dallas/Fort Worth area, where she was editor of the Arlington Daily News, she has more than two decades of journalism experience. Prior to joining the staff, she covered higher education for the Tampa Tribune. Koehn twice has won the Florida Society of Newspaper Editors’ Paul Hansell Award, which recognizes “overall excellence in writing and reporting,” based on body of work. She has a master’s degree in social work from the University of Texas. Shecan be reached by email or call (941) 361-4903.

Last modified: September 30, 2013
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